DIAGNOSIS. 339 



which the os tincse is to be found, in the shape of a tubercle, more 

 rounded, shorter, and particularly, less movable than the tongue. 



§. III. Of the Prognosis. 



810. After having established the diagnosis, a new question natu- 

 rally presents itself to the mind of the accoucheur, while it is very 

 soon propounded to him also by the patient herself or her attendants. 

 Will the delivery be prompt and easy, or slow and difficult? When 

 will it take place? The answer here is an extremely delicate mat- 

 ter, and ought only to be given after maturely weighing it, and then, 

 with the greatest reserve. The duration of labor is so variable 

 depends upon circumstances so diverse, and sometimes so unex- 

 pected, that it is often impossible for the most skilful practitioner to 

 fix it beforehand, even approximatively. On the one hand, it would 

 be necessary from the very beginning to know the proportions of 

 the foetus and pelvis, with how much energy the womb shall con- 

 tract, and how often the pains shall succeed each other; on the 

 other, he ought to be able to affirm that the progress of the 

 labor shall or shall not be interfered with by a hemorrhage, an 

 attack of convulsions, a prolapsion of the cord, or some other acci- 

 dent; that the fairest and best position shall not be converted to an 

 abnormal one; that the membranes shall give way at such a particular 

 period, and not at any other; that there shall or shall not occur a 

 spasmodic resistance of the cervix, &c. Now, none but ignorant 

 women or impudent quacks can pronounce upon all these points, and, 

 in spite of so many uncertainties, say at what hour the labor is to 

 terminate. 



811. All that we are permitted to promise in a general way is 

 the following: the child is well situated; the pelvis is neither small 

 nor deformed; the genital organs are healthy and well disposed; 

 the OS uteri soft and very dilatable; the pains occur regularly and 

 with constantly increasing force; the woman is courageous and well 

 constituted; therefore the termination of the labor will be prompt 

 and fortunate; a little less prompt if it be a first labor; a little 

 more so if she have had several children before, and still more so, 

 even too rapid, if the pelvis be possessed of excessive amplitude. 

 On the other hand, the position of the foetus, without being posi- 

 tively bad, is not, however, one of the best, or perhaps it may be a 

 very large one; the pelvis is slightly contracted; its axes are too 

 much or not sufficientlyJnclined; the os uteri is hard, or covered 

 with cicatrices; the woman is of a delicate, nervous, or lymphatic 

 constitution; in all these, we ought to fear that the labor may be- 

 come a long one, and that the resources of art may become neces- 



